General Health

Finding the Right Medicare Advantage Plan for Seniors

Medicare offers Medicare Advantage Part C plans to clients and directs a fixed amount each month to participating companies. Companies must follow all Medicare rules, and each Medicare Advantage Plan can charge out of pocket costs and follow different rules. Medicare Advantage Plans generally have additional coverage like dental, hearing, vision, and wellness programs. You will also continue with your Prescription Drug Coverage Part D benefits that are furnished by traditional Medicare.

Before deciding on what company to sign up with, compare different Medicaid Advantage plans side by side. Look for cost-effective plans, a variety of available programs, plans that offer out of country coverage as well as coordinated care from in-network providers. Once you find the best company for your needs, you have three months before or after your 65th birthday to enroll. When searching for a Medicare Advantage Part C plan, look for plans that offer:

1. Cost effectiveness

Before you enroll in any MA plans, check to find out what costs are involved. Costs may include:

  • Average monthly MA plan premiums that can range anywhere from $0 to $200 or more. You need Medicare Parts A & B to join a Medicare Advantage plan.
  • Deductibles are required on some MA plans. You may find that there are deductibles on Prescription Drug Coverage Part D.
  • Copayments are often required. Most Medicare Advantage plans do not have copays, but you need to find out by comparing plans.

2. Various plans available

Medicare Advantage health plans are offered by private insurance companies like Blue Cross and Blue Shield. Various plans include Health Maintenance Organization (HMO) Plans, Preferred Provider Organization or PPO plans, Private Fee for Service (PFFS) plan, and Special Needs Plans or SNPs.

3. Coordinated Care from in-network providers

Coordinated care synchronizes a patient’s health care from many providers and specialists in the in-network plan. Health outcomes are improved by ensuring that care from different providers works together. In other words, each provider receives the records and care procedures from other providers in-network to avoid higher costs, duplicated tests, and lost time. Coordinated care is a tremendous benefit of Medicare Advantage and is designed to give patients the best care at the most cost effective rates.

4. Out of country coverage

If you travel out of the United States and its territories, and you have Medicare Advantage, the rules depend on the type of Medicare Advantage enrolled plan. If you use Medicare Advantage HMOs, you must use specific providers to be covered for routine care. If you have PPO plans, you may see healthcare providers outside your plan’s provider network. You will possibly need to pay a higher deductible. Check with your Medicare Advantage plan for more information when you are planning to travel.

5. Anytime enrollment

Medicare’s annual open enrollment period from October 15 until December 7, allows seniors (65-years or older) the opportunities to enroll in a Medical Advantage Plan Part C, change an existing Part C or D plan and disenroll and go back to original Medicare. However, you can enroll in Medicare Advantage, according to the Centers for Medicare & Medicaid Services (CMS), from January 1 to March 31. You can also contact your State Health Insurance Assistance Program or SHIP in your state if you have circumstances that require you to change Medicare plans.

For more information about Medicare Advantage (Part C) plans, please visit companies like Blue Cross and Blue Shield online and enter a zip code to find the plans available in your state. 


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